Case Reports

CI patient #128 was a 32 year old female who died in Arizona on January 4th, 2015. The cause of death was Acute Myelogenous Leukemia. The patient was a CI member at the time of her death.

The next of kin had contracted with a local funeral director to provide initial cooling and transport services. The patient died at approximately 6:30am on January 4th, 2015. The patient was picked up by the cooperating funeral director and packed in water ice and was taken to the cooperating funeral directors facility, where she was maintained in water ice. Heparin was not administered.

The patient arrived at the CI facility, packed in water ice at approximately 7:30pm on the 6th of January. Jim and Sara Walsh, CIs local cooperating funeral directors, were both present for the perfusion and the perfusion began at 7:45pm. No clotting of the blood was observed during the perfusion. The body and head were both perfused and a flow rate of 1.66 liters per minute was maintained at 118mm pressure.

The perfusion was completed at 8:45pm. During the perfusion there were 2 liters of 10% Eg solution used, 4 liters of 30 % Eg solution used and 30 liters of 70% VM1 solutions used. The final refractive index of the effluents exiting the right jugular vein was 1.4168. The final refractive index of the effluents exiting the left jugular vein was 1.40. The perfusion was terminated before the desired refractive index of 1.424 was achieved because the flow from the jugular veins from the head decreased to the point of almost stopping and edema was starting to appear in the face. No edema was noted in the body and bronzing of the skin and dehydration was noted all the way to the toes and finger tips.

The patient was then placed in the computer controlled cooling chamber to cool to liquid nitrogen temperature. The human vitrification program was selected and the time needed to cool the patient to liquid nitrogen temperature was five days and 14 hours. The patient was then placed in a cryostat for long-term cryonic storage.

Comments: The state of Arizona will not issue any paperwork for transit on the weekends, and this caused a delay in getting the patient to CI. The perfusion went quite well, especially considering that there was about 60 hours of cold ischemia. The reason for this could be that the patient was quickly packed in water ice and the patient was thin, which would allow the patient to cool down faster. Less amounts of the 10% and 20% solutions were used in the perfusion because past experiences have shown that we can obtain better saturation of the tissue with vitrification solution, with less edema, if we use less amounts of the lower concentrations of solutions and advance quicker to the 70% solution when there is more than 24 hours of cold ischemia. The reasons for no clotting of the blood, though no heparin was administered, are unclear. It may be possible that the medications the patient was receiving as treatment for Leukemia helped to prevent coagulation, but at the time the report was written the types of medication the patient was receiving are unknown.

Cryonics Institute Case Report for Patient Number 126 Peter Renzo (name public per family request)

CI patient #126 was a 91 year old male who died in a New Jersey hospital on September 8th, 2014. The patient was a CI member at the time of his death.

The Cryonics Institute and the patient had arranged ahead of time with a local funeral director to provide the initial cooling and transportation arrangements. The patient died at 8:15am on September 8th, 2014. The patient was packed in water ice and taken to the hospital morgue for further cooling. The funeral director reported that chest compressions were applied in order to help accelerate the cooling process. Heparin was not administered by the hospital due to their policy preventing it, but the patient was receiving high doses of Cumidin while in the hospital.

The patient arrived at the CI facility, packed in water ice at approximately 8 pm on the 9th of September. The deep nasal temperature of the patient was 2.6c. Sara Walsh, CIs local cooperating funeral director, and an assistant were both present for the perfusion, along with two CI employees, and the perfusion began at 8:30pm. Very little clotting of the blood was observed. The perfusion was a full body perfusion.

The perfusion was completed at 9:45pm. During the perfusion there were 2 liters of 10% Eg solution used, 6 liters of 30 % Eg solution used and 36 liters of 70% VM1 solutions used. The flow rate during perfusion was steady and averaged 1.37 liters per minute until the very end where it was reduced to .25 liters per minute in order to keep the pressure from rising in the patient. The pressure during perfusion was held at 120mm. The final refractive index of the effluents exiting the right jugular vein was 1.415. The final refractive index of the effluents exiting the left jugular vein was 1.419. Dehydration of was noted in the head, face and parts of the body along with a bronzing color of the skin where dehydration was present. Near the end of the perfusion there was some edema noted in the face, but no edema was noted in the brain by observation through the burr hole in the skull. The temperature of the nasal thermocouple was -2.4c at the end of the perfusion.

The patient was then cooled to liquid nitrogen temperature. The human vitrification program was selected on the computer controlled cooling unit and the time needed to cool the patient to liquid nitrogen temperature was five and a half days. The patient was then placed in a cryostat for long-term cryonic storage.

Comments: CI uses less perfusion solutions of lower concentration, and more of the higher concentration when the perfusion is conducted more than 24 hours after the death of the pateint. This helps to reduce edema and allows for more of the cryoprotective solutions to be absorbed into the tissue. The delay in having the patient sent to CI resulted in part because the funeral director did not have a Ziegler shipping case on hand and needed to to obtain one in the morning before shipping could take place. This was not the fault of the funeral director we used because he was actually a backup funeral director that filled in because the original funeral director backed out at the last minute. For those of our members who are relying on a local funeral director to transport them to CI, it would be best to confirm that they do keep a Ziegler shipping case on hand in case of an emergency in order to eliminate possible delays.